DIFINITION, CLINICAL FEATURES AND ETIOLOGY OF AORTIC STENOSIS

Definition

Aortic Stenosis

1. Aortic Stenosis – Is the narrowing of the orifice between the left ventricle and the aorta
2. The obstruction to the aorta outflow put a pressure load on the left ventricle resulting into hypertrophy and failure

 Causes of aortic Stenosis

1. Rheumatic fever
2. Arteriosclerosis
3. Congenital

 Clinical features

1. Exertional, dysponea and fatigue
2. Dizziness and fainting because of reduced volume of blood going to the brain
3. Angina pectoris due to increased Oxygen demands
4. Low B/P and low pulse pressure from diminished blood flow (30mmHg or less)
5. Dysrhythmias
6. Symptoms of heart failure
7. In physical examination laud, rough systolic murmur heard over the aortic area

 Diagnostic evaluation

1.      Chest X-ray – show left ventricle enlargement

2.      Physical examination

3.      Cardiac catheterization- Will reveal pressure in the left ventricle and aorta

4.      Angiocardiagraphy-  Will reveal pressure in the left ventricle and aorta

5.      Echocardiography-  Will reveal pressure in the left ventricle and aorta

6.      ECG

Treatment

1. Surgical replacement of aortic valve – prosthetic device or aortic valve homograft
2. Treat angina and heart failure

 Definition of Aortic incompetence

1. Aortic incompetence (regurgitation) is caused by an inflammatory lesion that deforms the flaps so that they fail to seal the aortic orifice, during diastole thus permitting a back flow of blood from the aorta into the left ventricle.

  Causes Aortic incompetence

1. Rheumatic endocarditis
2. Bacterial endocarditis
3. Congenital malformation
4. Syphilis disease
5. Rheumatoid spondylitis
6. Dissecting aneurysm

 Clinical features (signs and symptoms)

1. Exertional dyspnoea and fatique
2. Insidious onset
3. Increased force of heart beat
4. Palpable arterial pulsation over the precardium and neck
5. Signs of left ventricular failure
6. Chest pain
7. Palpitations
8. Diastolic murmur
9. Symptoms of heart failure

 Diagnostic evolution

1. ECG left ventricular hypertrophy
2. Chest X-ray  - shows  Cardiomegally
3. Echocardiography – estimates size and thickness of left ventricle
4. Cardiac catheterization and angiography

 Treatment

1. Surgical intervention – Replacement of damaged aortic valve is the treatment of choice
2. If patient has signs of congestive heart failure medical management is recommended until surgery can be performed.